Provider Demographics
NPI:1386479756
Name:HILDEBRAND, PAMELA (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:HILDEBRAND
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 WALLING ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-3653
Mailing Address - Country:US
Mailing Address - Phone:415-638-9492
Mailing Address - Fax:
Practice Address - Street 1:1116 WALLING ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-3653
Practice Address - Country:US
Practice Address - Phone:415-638-9492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122686235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist